Provider Demographics
NPI:1366460123
Name:SIMON, JOSHUA S (MD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:S
Last Name:SIMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8500-6335
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:215-807-8000
Mailing Address - Fax:215-807-8235
Practice Address - Street 1:3998 RED LION RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1436
Practice Address - Country:US
Practice Address - Phone:215-612-4000
Practice Address - Fax:215-807-8235
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417084207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01906447-03OtherAMERICHOICE TORRESDALE
PA07645OtherHEALTH PARTNERS
PA452729OtherAETNA CONTRACT
PA0019064470001Medicaid
PA01906447-02OtherAMERICHOICE FRANKFORD
PA1050681OtherCIGNA
PA20045166OtherAMERIHEALTH MERCY
PA2085833000OtherKEYSTONE IBC
PA1396967OtherHIGHMARK BLUE SHIELD
PA1396967OtherPERSONAL CHOICE
PA0019064470003Medicaid
PA01906447-01OtherAMERICHOICE BUCKS
PA0019064470002Medicaid
PA1164089OtherKEYSTONE MERCY
PA0019064470002Medicaid
PA059525JL1Medicare PIN